Active NPI
Stefanie Corral-Enriquez
- Student in an Organized Health Care Education/Training Program
- Albuquerque, NM
National Provider Identifier
1316453889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2600 Marble NE Building 2
Albuquerque, NM 87131-2360 - Phone
- (505) 272-2190
- Fax
- (505) 272-3466
- NPI assigned
- Dec 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NM | ||
| School Social Worker | 1041S0200X | NM | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | Primary |
Addresses
Primary practice location
2600 Marble NE Building 2
Albuquerque, NM 87131-2360
Mailing address
707 Broadway Blvd NE
Albuquerque, NM 87102-2360
Phone (505) 345-8471
Other practice location 1
707 Broadway Blvd NE
Albuquerque, NM 87102-2360
Phone (505) 345-8471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1316453889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 BROADWAY BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871022360",
"telephone_number": "505-345-8471",
"fax_number": "505-342-5450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 MARBLE NE BUILDING 2",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871312360",
"telephone_number": "505-272-2190",
"fax_number": "505-272-3466"
}
],
"practiceLocations": [
{
"address_1": "707 Broadway Blvd NE",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871022360",
"country_code": "US",
"telephone_number": "505-345-8471",
"fax_number": "505-342-5450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORRAL-ENRIQUEZ",
"first_name": "STEFANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-20",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.